Take special care when you are sick.

When you’re feeling ill, don’t assume that diabetes or its management is to blame.

There are many causes of illness. For example, you could have flu, pneumonia, appendicitis, heart attack or stroke, for which you need specialized care. Do not assume that all illnesses are related to diabetes or its management. Always be safe and seek medical evaluation.

Having diabetes requires you to take special care when you are sick.

When you are sick, your body releases extra stress hormones that cause your blood sugar to rise, and increase your risk of Hyperglycemic Hyperosmolar States (HHS) (Type 2 only) and very rarely Diabetic Ketoacidosis (DKA). Be sure to monitor your blood sugar. If your blood sugar is high or you are very ill or vomiting, you need to contact your medical provider or go to the Emergency Department at your nearest hospital. Ask your provider for sick day guidelines specific for you.

General checklist for sick days:

Monitor blood glucose every 2-4 hours (Type 1) or 4 to 12 (Type 2) or as recommended by your provider.

Drink plenty of fluids, including those that have salt, such as soup bouillon.

Check urine or blood ketones, especially if your blood glucose is high or if you are nauseated and vomiting. If ketone levels are elevated, you need to seek immediate medical attention.

You need immediate medical attention if you have:

Persistent nausea, vomiting or diarrhea

Difficulty breathing

Trouble moving arms or legs

Vision, speech or balance problems

Feel you are unable to take care of yourself

Persistent blood glucose levels of more than 250 mg/dl

Persistent fever or signs of worsening infection

Urine or blood ketones above normal

People often wait too long to get medical care and may become very ill. Delay in seeking care can be life-threatening.

KEEP A CLOSE WATCH ON DIABETES WARNING SIGNS WHEN YOU’RE SICK. IF NECESSARY, GET MEDICAL ATTENTION IMMEDIATELY.

Some illnesses require immediate care at the Emergency Department, while others can be managed by consulting your doctor. When in doubt or if you can’t reach your provider, go to an urgent care clinic or Emergency Department.

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